This study explored the experiences of men living with sexual dysfunction as a consequence of having been treated for prostate cancer. An ethnoculturally diverse sample of 18 men (14 heterosexual, and four homosexual) participated in a series of four to five in-depth interviews. These one-on-one interviews were designed to elicit information pertaining to their beliefs, values and performances regarding masculinity vis-a-vis prostate cancer and its treatment. Interview transcripts were analyzed using the grounded theory method. The core category of ‘Preserving Manhood’ incorporated five major themes: enhancing the odds; disrupting a core performance; baring an invisible stigma; effortful-mechanical sex; and working around the loss. We conclude that men’s performances of sexuality and masculinity were highly interwoven; that loss of sexual functioning constituted a focal disruption for participants; and in some instances, posed a significant threat to their masculine identities.
Andersen, B. L. (1985). Sexual functioning morbidity among cancer survivors: Current status and future research directions. Cancer, 55, 1835-1842.
2.
Barber, K. R. , Shaw, B., Folts, M., Taylor, K., Ryan, A., Hughes, M., Scott, V., & Abbott, R. R. (1998). Differences between African American and Caucasian men participating in a community-based prostate screening program. Journal of Community Mental Health, 23, 441-451.
3.
Braslis, K. G. , Santa-Cruz, C., Brickman, A. L., & Soloway, M. S. (1995). Quality of life 12 months after radical prostatectomy. British Journal of Urology, 75, 48-53.
4.
Brendler, C. B. , & Walsh, P. C. (1992). The role of radical prostatectomy in the treatment of prostate cancer. CA A Cancer Journal for Clinicians, 42, 212-222.
5.
Doyle, J. A. (1995). The male experience, 3rd edn.Boston, MA: McGraw Hill.
6.
Feldman, H. A. , Goldstein, I., Hatzichristou, D. G., Krane, R. J., & McKinlay, J. B. (1994) Impotence and its medical and psychosocial correlates: Results of the Massachusetts male aging study. Journal of Urology, 151, 54-61.
7.
Fracher, J. , & Kimmel, M. S. (1987). Hard issues and soft spots: Counseling men about sexuality. In S. Murray & M. Stevens (Eds.), Handbook of counseling and psychotherapy with men (pp. 83-96). Newbury Park, CA: Sage.
8.
Glaser, B. G. (1978). Theoretical sensitivity: Advances in the methodology of grounded theory. Mill Valley, CA: The Sociology Press.
9.
Glaser, B. G. , & Strauss, A. (1967). The discovery of grounded theory: Strategies for qualitative research. Chicago, IL: Aldine.
10.
Gray, R. E. , Fitch, M. I., Phillips, C., Labrecque, M., Fergus, K. D., & Klotz, L. (2002). Prostate cancer and erectile dysfunction: Men’s experiences. International Journal of Men’s Health, 1, 5-20.
11.
Hassouna, M. M. , & Heaton, J. P. W. (1999). Prostate cancer: 8. Urinary incontinence and erectile dysfunction. Canadian Medical Association Journal, 160, 78-86.
12.
Helgason, A. R. , Adolfsson, J., Dickman, P., Fredrikson, M., Arver, S., & Steineck, G. (1996). Waning sexual function—the most important disease-specific distress for patients with prostate cancer. British Journal of Cancer, 73, 1417-1421.
13.
Helgason, A. R. , Fredrikson, M., Adolfsson, J., & Steineck, G. (1995). Decreased sexual capacity after external radiation therapy for prostate cancer impairs quality of life. International Journal of Radiation Oncology and Biological Physics, 32, 33-39.
14.
Koeman, M. , van Driel, M. F., Schultz, W. C., & Mensink, H. J. (1996). Orgasm after radical prostatectomy. British Journal of Urology, 77, 861-864.
15.
Lilleby, W. S. , Fossa, D., Waehre, H. R., & Olsen, D. R. (1999). Long-term morbidity and quality of life in patients with localized prostate cancer undergoing definitive radiotherapy or radical prostatectomy. International Journal of Radiation Oncology and Biological Physics, 43, 735-743.
16.
Littrup, P. J. (1997). Future benefits and cost-effectiveness of prostate carcinoma screening. Cancer, 80, 1864-1870.
17.
Litwin, M. S. , Hays, R. D., Fink, A., Ganz, P. A., Leake, B., Leach, G. E., & Brook, R. H. (1995). Quality-of-life outcomes in men treated for localized prostate cancer. Journal of the American Medical Association, 273, 129-135.
18.
Morris, L. A. (1998). Gender role stress and male erectile disorder. In W. S. Pollack & R. F. Levant (Eds.), New psychotherapy for men (pp. 191-213). New York: John Wiley & Sons.
19.
Morrison, H. I. , MacNeill, I. B., Miller, D., Levy, I., Xie, L., & Mao, Y. (1995). The impending Canadian prostate cancer epidemic. Canadian Journal of Public Health, 86, 274-278.
20.
National Cancer Institute (NCI). (1999). Prostate cancer trends 1973-1995. (On-line) Available at: http://seer.cancer.gov/Publications/ProstMono/.
21.
National Cancer Institute of Canada (NCIC). (2001). Canadian cancer statistics 2001. (On-line) Available at: http://www.cancer.ca/stats/currente.htm.
22.
Perelman, M. (1984). Rehabilitative sex therapy for organic impotence. In R. T. Segraves & E. J. Haeberle (Eds.), Emerging dimensions of sexology (pp. 181-188). New York: Praeger.
23.
Perez, M. A. , Meyerowitz, B. E., Lieskovsky, G., Skinner, D. G., Reynolds, B., & Skinner, E. C. (1997). Quality of life and sexuality following radical prostatectomy in patients with prostate cancer who use or do not use erectile aids. Urology, 50, 740-746.
24.
Person, E. S. (1980). Sexuality as the mainstay of identity: Psychoanalytic perspectives. Signs, 5, 605-630.
25.
Potts, A. (2000). ‘The essence of the hard on’: Hegemonic masculinity and the cultural construction of ‘erectile dysfunction’. Men and Masculinities, 3, 85-103.
26.
Quinlan, D. M. , Epstein, J. I., Carter, B. S., & Walsh, P. C. (1991). Sexual function following radical prostatectomy: Influence of preservation of neurovascular bundles. Journal of Urology, 145, 998-1002.
27.
Rennie, D. L. , Phillips, J. R., & Quartaro, G. K. (1988). Grounded theory: A promising approach to conceptualization in psychology?Canadian Psychology, 29, 139-150.
28.
Rennie, D. L. & Fergus, K. D. (2001). ‘It rises from my gut’: Embodied categorizing in grounded theory analysis. Paper presented at the bi-annual meeting of the International Society for Theoretical Psychology, June, Calgary.
29.
Richards, L. (1999). Using N-Vivo in qualitative research. London: Sage.
30.
Robinson, J. W. , Dufour, M. S., & Fung, T. S. (1997). Erectile functioning of men treated for prostate carcinoma. Cancer, 79, 538-544.
31.
Rosen, R. C. (1996). Erectile dysfunction: The medicalization of male sexuality. Clinical Psychology Review, 16, 497-519.
32.
Rustka, K. M. , Partin, A. W., Epstein, J. I., & Kahane, H. (1999). Adenocarcinoma of the prostate in men younger than 40 years of age: Diagnosis and treatment with emphasis on radical prostatectomy findings. Urology, 53, 1179-1183.
33.
Schover, L. R. (1993). Sexual rehabilitation after treatment for prostate cancer. Cancer (Supplement), 71, 1024-1030.
34.
Schover, L. R. (1996). The impact of cancer-related sexual problems in men on family relationships. In L. Baider, C. L. Cooper, & A. Kaplan De-Nour (Eds.), Cancer and the family (pp. 321-336). New York: John Wiley & Sons.
35.
Stanford, J. L. , Feng, Z., Hamilton, A. S., Gilliland, F. D., Stephenson, R. A., Eley, J. W., Albertsen, P. C., Harlan, L. C., & Potosky, A. L. (2000). Urinary and sexual function after radical prostatectomy for clinically localized prostate cancer: The prostate cancer outcomes study. Journal of the American Medical Association, 283, 354-360.
36.
Steginga, S. K. , Occhipinti, S., Dunn, J., Gardiner, R. A., Heathcote, P., & Yaxley, J. (2000). The supportive care needs of men with prostate cancer. Psycho-Oncology, 10, 66-75.
37.
Stock, W. (1988). Propping up the phallocracy: A feminist critique of sex therapy and research. Women & Therapy, 7, 23-41.
38.
Stoltenberg, J. (1984). Refusing to be a man. Women’s Studies International Forum, 7, 25-27.
39.
Tepper, M. S. (1999). Letting go of restrictive notions of manhood: Male sexuality, disability and chronic illness. Sexuality and Disability, 17, 37-52.
40.
Tiefer, L. (1986). In pursuit of the perfect penis: The medicalization of male sexuality. American Behavioral Scientist, 29, 579-599.
41.
Walsh, P. C. , & Donker, P. J. (1982). Impotence following radical prostatectomy: Insight into etiology and prevention. Journal of Urology, 128, 492-497.
42.
Zilbergeld, B. (1992). The new male sexuality. New York: Bantam Books.
